Kidney Graft Weight as an Important Risk Factor for Long-Term Graft Survival

Nishimura, Yuichi; Tomikawa, Shinji; Beck, Yoshifumi; Nomura, Yukihiro; Ando, Yumiko; Kikuchi, Kenji; Ichikawa, Naoya; Meigata, K; Mutô, Toshinosuke; Inoue, Sumio; Kuzuhara, K; Degawa, Hisakazu; Nagao, Toshiyasu; Kuriyama, Renjiro; Uchida, Hiroshi

doi:10.1016/s0041-1345(97)01194-9

Cited by 14 publications

(11 citation statements)

References 12 publications

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“…We conducted a MED-LINE search for studies that have investigated the effects of donor-recipient size mismatching on kidney graft survival (Table 2). We identified 11 published studies, but 6 had not yet been published in a peer-reviewed journal, and many details of the analysis in these 6 studies were missing (10,13,16,20,33,34). There were 8 single-center studies, (10 -17) and it is likely that many of these single-center studies lacked adequate statistical power to test the hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…There were 8 single-center studies, (10 -17) and it is likely that many of these single-center studies lacked adequate statistical power to test the hypothesis. Indeed, 4 studies included fewer than 200 patients (10,14,15,17). Many of the studies failed to use a multivariate analysis to eliminate possible confounding from the effects of other variables (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Many of the studies failed to use a multivariate analysis to eliminate possible confounding from the effects of other variables (Table 2). In fact, none of the 4 studies reporting a statistically significant effect of donor-recipient size disparity on graft survival performed a multivariate analysis (10,11,13,20). In addition, 7 studies used recipient body weight rather than BSA as a measure of recipient size (10,13,(15)(16)(17)33,34).…”

Section: Discussionmentioning

confidence: 99%

“…Some investigators have reported reduced graft survival in situations in which the size of the donor kidney would be expected to be reduced in proportion to the size of the recipient (10,11). Other single-center studies found no effect of donor-recipient size mismatching on graft survival (12)(13)(14)(15)(16)(17).…”

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confidence: 99%

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Inadequate Donor Size in Cadaver Kidney Transplantation

Kasiske¹,

Snyder²,

Gilbertson³

2002

Journal of the American Society of Nephrology

119

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Abstract. There have been conflicting reports that kidneys from small donors may be at increased risk for late graft failure if they are transplanted into large recipients. Data from the United States Renal Data System was used to study all first cadaver kidney transplantations performed during the years 1994 to 1999. Donor and recipient body surface area (BSA) combinations were included along with other patient and transplant characteristics in a Poisson analysis of factors associated with early (in the first 4 mo) and late (Ն4 mo) graft failure. The numbers of large (BSA Ͼ2.2 m 2 ) and medium size (BSA 1.6 to 2.2 m 2 ) recipients that received kidneys from small (BSA Ͻ1.6 m 2 ) donors are less than expected ( 2 ϭ 118.09; P Ͻ 0.0001), suggesting that transplant centers may be refusing some kidneys on the basis of donor-recipient size differences. Large recipients who received kidneys from small donors made up 1.5% of the population and had a 43% (95% CI, 17 to 75%; P ϭ 0.0004) increased risk of late graft failure compared with medium-size recipients who received kidneys from mediumsize donors (53.4% of the population). Medium-size recipients who received kidneys from small donors made up 12.0% of the population and had a 16% (95% CI, 6 to 26%; P ϭ 0.0012) increased risk of late graft failure. Disparities in recipient and donor size had similar adverse affects on mortality. Effects of recipient obesity (body mass index) and donor gender on late graft survival were no longer statistically significant after the effects of donor and recipient body size were taken into account. In conclusion, the relative size of the donor and recipient should possibly be taken into account when choosing kidneys for transplantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Inadequate Donor Size in Cadaver Kidney Transplantation

Kasiske¹,

Snyder²,

Gilbertson³

2002

Journal of the American Society of Nephrology

119

View full text Add to dashboard Cite

show abstract

“…In order to prevent hyperfiltration, it is important to initially provide an adequate functioning nephron number to meet the metabolic demands of a recipient as well as to allow adequate nephron mass in case of rejection episodes, nephrotoxic drugs, or other potential injuries. 5,6 During the preoperative evaluation of a potential kidney donor, it is necessary to estimate the renal function of the donated kidney compared with the metabolic needs of the recipient. In this study, we determined the correlation between the preoperative function of the donated kidney and the postoperative graft function of the recipient at 1 year posttransplantation.…”

Section: Arly Graft Function In Renal Transplant Recip-mentioning

confidence: 99%